[Show abstract][Hide abstract] ABSTRACT: Urinary incontinence (UI) is considered a public health problem that should be firstly approached in the primary care units (PCU). Educational programs target to professionals who work in these units are a key component in the management of this condition. The aim of this study was to report the experience of the "Caring for Who Cares", a project developed in a PCU aimed at educating employees about UI. The educational program was carried out as a dynamic, with theoretical and practical character, lasting 2 hours. The 28 participants were divided into 2 groups. Each group participated in the program on different days so that the usual activities of the PCU could be maintained. Issues such as types of UI, risk factors, preventive and therapeutic measures, especially urinary and bowel habits and pelvic floor muscle (PFM) training, were discussed. The participants reported being more attentive to their urinary habits after the educational program; some of them had incorporated exercises for the PFM. There were also an increasing number of users referred to the physiotherapy care service. Therefore, the project successfully educated the employees of the PCU for their own care and allowed the implementation of UI preventative and treatment programs in this unit. This experience may be helpful to other professionals when implementing the physical therapy assistance for women with UI in PCU.
[Show abstract][Hide abstract] ABSTRACT: This study aimed to investigate obstetrical, neonatal, and clinical predictors of stress urinary incontinence (SUI) focusing on pelvic floor muscle (PFM) strength after vaginal delivery.
A cross-sectional study was used, and potential predictors of SUI were collected 5-7 months postpartum on 192 primiparous women. Predictors that reached significance in the bivariate analysis were entered into the Classification and Regression Tree that identified interactions among them and cutoff points to orient clinical practice.
PFM strength was the strongest predictor of SUI. A combination of PFM strength ≤ 35.5 cmH(2)O, prior SUI, newborn weight > 2.988 g, and new onset of SUI in pregnancy predicted SUI. The model's accuracy was high (84%; p = 0.00).
From the four predictors identified, three are modifiable by physical therapy. This could be offered to women targeting at PFM strength >35.5 cmH(2)O at the postpartum as well as at the prevention of SUI before and during pregnancy.
International Urogynecology Journal 03/2012; 23(7):899-906. DOI:10.1007/s00192-012-1681-7 · 1.96 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The 6-minute walk test (6MWT) is a simple and reliable method routinely used in the evaluation of many conditions including cardiac diseases. However, it is rarely performed in patients with pacemakers (PMs), and the applicability and safety in this group is not established. The purpose of this study was to verify the applicability and safety of the 6MWT in the evaluation of functional capacity of patients with PMs, considering the ergometry test (ET) as the criterion standard.
Twenty-four patients with rate-responsive PMs underwent a treadmill ET, using the Chronotropic Assessment Exercise Protocol, and a 6MWT, performed twice with a rest interval of 20 minutes. Functional capacity, heart rate, and blood pressure in each test were recorded.
The distance covered during the 6MWT significantly correlated with the oxygen uptake estimated from the treadmill ET (r = 0.709, P < .001). Peak heart rates and systolic blood pressure levels reached during the 2 tests were also significantly correlated. No adverse events or malignant arrhythmias were observed during the 6MWT. The distance walked during the 6MWT accurately predicted the patient performance on the ET (area under the receiver operating characteristic curve = 0.921). The ability to walk more than 538 m in the 6MWT predicted, with a sensitivity of 90% and a specificity of 79%, an estimated oxygen uptake above 10 metabolic equivalents (METs) on the ET.
The 6MWT can be considered safe to assess the submaximal functional capacity and can be used as an alternative test to evaluate the results of interventions in patients with permanent cardiac PMs.
Journal of cardiopulmonary rehabilitation and prevention 07/2008; 28(4):253-7. DOI:10.1097/01.HCR.0000327183.51992.76 · 1.58 Impact Factor